COLUMBUS (AP) — A group that six years ago settled a lawsuit saying Ohio prisoners received inadequate health care is watching as state lawmakers consider a budget plan that would cut about $44 million in funding for inmate medical costs by 2013.

The Dayton Daily News reports Sunday that the annual medical care cost for the state’s 51,000 prisoners was about $223 million. The average spent per inmate in 2010 was $4,371, compared to $2,365 in 2001.

Prison inmates are the only residents guaranteed health care in the state constitution.

Attorney David Singleton of the Ohio Justice Policy Center, which filed the federal lawsuit in 2003, told the Daily News conditions in the prisons system at the time were “absolutely deplorable.”

The suit, settled in 2005, led to 310 more medical staff and $28 million more in annual expenses, according to the legislative Correctional Institution Inspection Committee.

Singleton said the group will watch in hopes that progress made won’t be undone.

“If it undoes the progress to the point that care is unconstitutional, we’ll be back in court,” he said.

The two-year state budget plan now before the state Senate would cut 18.4 percent from prison medical services between 2011 and 2013. The $239 million annual budget would drop to $209 million next year and $195 million in two years.

Officials have taken steps to reduce inmate medical costs, such as having a managed care contractor to review hospital stay bills and inmate stays, starting a program to manage inmates with chronic diseases, introducing healthier meals and banning tobacco use.

The prisons department also requests permission from judges to release prisoners with significant or terminal medical conditions. Since late 2006, 35 inmates have been released and the department is requesting six more.

“We have a lot of sick inmates. That is the bottom line,” said Medical Services Chief Stuart Hudson. “Even though they’re in the physical or mental state that they’re in, we can’t release them by law. We have no other option other than to care for them.”